Frozen Section Techniques Used in Mohs Micrographic Surgery

Abstract

The chapter offers a comprehensive discussion of the technical process of preparing frozen sections in the setting of Mohs dermatographic surgery. In Mohs surgery procedure, the surgeon removes a skin cancer which is immediately examined by frozen section to access the resection margin. Most critical to accurate specimen preparation is the proper on face embedding of tissues such that the epidermal edge, deep and lateral margins are embedded in a single flat plane. Techniques for relaxing the tissues are discussed and illustrated in detail. Techniques traditionally used by Mohs technologists including slide technique, heat extractor technique, and embedding in plastic molds are described. Technical advances in embedding using innovative apparatus include, techniques using the Cryo-embedder, the Miami Special and the Precision Cryoembedding System. The chapter covers aspects critical to the cutting and staining of tissue sections for Mohs surgery.